1. Field of the Invention
The invention resides in the field of surgical apparatus and more particularly relates to instruments for performing laparoscopic and endoscopic surgical procedures having an end portion capable of articulated or pivotal movement within a patient's body.
2. Description of the Prior Art
Minimally invasive surgery (MIS) has, in recent years, become important in hospitals and surgical centers. In MIS procedures, small incisions are made in the patient's body to provide access for various surgical devices for viewing and operating inside the patient. Using specially designed instruments such as a laparoscope or endoscope, trained surgeons can see directly inside the human body and perform operations using specially designed laparoscopic surgical instruments. Laparoscopic surgical instruments include scissors, dissectors, graspers and retractors. These instruments generally consist of a handle which remains outside of the patient's body and which is used by the surgeon to control the operation of the instrument, an elongated tubular section which fits through a tube or trocar device entering the patient's body, and a distal tip used to execute the particular procedure.
Many examples of MIS instrumentation exist in the prior art. Some early instruments were essentially elongated scalpels or probes. Early instruments with handles permitted opening and closing of the distal tip elements. Somewhat later instruments came to have axis rotation as a common feature. Axis rotation gave surgeons increased flexibility in the positioning of the elements of the distal tip.
A continuing limitation for surgeons has been the lack of flexibility of these instruments through the tubular section to the distal tip elements. To cope with the limitations of these instruments, surgeons may operate in teams with the instruments handed back and forth from surgeon to surgeon across the patient. Inability to reach around nerves and blood vessels may cause surgeons to resort to open surgery instead of continuing with a MIS procedure. By providing an easily manipulated, fully articulating distal tip, this invention increases the flexibility of laparoscopic surgical instruments, enabling surgeons to operate more safely, more quickly and efficiently, and with decreased risk to the patient.
An example of an endoscopic surgical instrument is illustrated in U.S. Pat. No. 2,113,246, Wappler. This patent discloses endoscopic forceps comprising an elongated conduit with jaws at the distal end thereof, a control rod in the conduit for controlling the operation of the jaws, and a control handle at the proximal end of the conduit which is operatively connected to the control rod.
Improvements have been made in the art of surgical instruments to increase their range of operability. For example, U.S. Pat. No. 4,763,669, Jaeger, discloses a microsurgery instrument with an adjustable angle of operation for obtaining cervical biopsies.
Similarly, U.S. Pat. No. 4,880,015, Nierman, discloses a surgical device having an increased range of operability. In particular, this patent shows a biopsy forceps designed for use through a flexible fiber optic bronchoscope. The biopsy forceps includes a handle connected to a thin elongated flexible shaft with a distal portion thereof hinged to the shaft. A grasping tool or biopsy forceps is attached to the distal hinged portion. Control wires extend from the handle to the distal end to the shaft for controlling the angular rotation of the distal portion of the instrument.
Further, U.S. Pat. No. 5,350,391 Iacovelli discloses a device having a pair of handles which may be operated in tandem to effect the orientation of a surgical instrument in a variety of positions.
Also of note is U.S. Pat. No. 5,330,502, Hassler et al., describing a mechanism utilizing a combination of a tube and knob to effect articulation of from zero to 90 degrees.
Similarly, U.S. Pat. No. 5,383,888 Boris Zvenyatsky, et al., discloses an endoscopic surgical instrument with rotation, electrocautery, and a limited 90-degree articulation achieved through linkages.
None of the instruments described above is flexible enough to address the wide range of requirements for surgical procedures performed internally to the patient's body. Further, none of the instruments described permits the surgical team to proceed as quickly and efficiently as would be desired under normal operating conditions. The instruments described lack the ability to rotate the distal tip about the longitudinal axis of the instrument while fully articulating the tip to any setting relative to the tubular section of the instrument. This lack of flexibility requires surgeons to manually rotate and move the instrument relative to the patient body to perform the procedure. In some cases the instruments described cannot perform the procedure due to the location of blood vessels and blocking tissues.
Accordingly it is an object of this invention to provide laparoscopic surgical instruments having a distal tip independently moveable about the two axis of rotation relative to the handle while the instrument is in use, giving greatly expanded flexibility to the surgeon for motion inside the patient body.
It is another object of this invention to provide a surgical instrument capable of supporting a variety of tool heads with frill motion capability. Individual heads may be used to cut, grasp, push, pull probe, electrocauterize, and perform other actions either singly or in combination.
It is another object of this invention to provide a lightweight laparoscopic surgical instrument which enables the surgeon to reach under and around both tissue and blood vessels during an operation.
It is a further object of this invention is to provide a laparoscopic surgical instrument of simplified and rugged construction which is inexpensive to manufacture relative to both disposable and reusable instruments in current use.
These and other objects of the invention will be more fully understood from the summary which follows.